Cosmetic eye surgery can be done with an external cut or inside the eye, leaving no mark
.JPG "Cosmetic eye surgery can be done both externally and internally, although the upper eyelid is generally done with an external incision.")
Q. One of my girlfriends had eye surgery and said they did it from the inside out. Is that even possible?
A. Yes, it’s possible. Your girlfriend probably had a trans-conjunctival blepharoplasty. She is likely talking about her lower eyelid surgery; the upper eyelid is generally done with an external incision.
Blepharoplasty, or eye surgery, can be done both externally and internally.
Upper eyelid surgery is straightforward in that the incision is made on the external skin in the normal crease. The idea is to remove extra skin and if there is bulging near the nose, remove parts of the medial fat pad. Most surgeons who perform this procedure do it in similar method.
The lower eyelid surgery is done externally when skin and some muscle needs to be removed along with three of the prominent fat pads. I generally start with the most lateral fat pad to remove the necessary fat so that the eye looks rejuvenated. Care must be taken not to take too much or leave extra fat.
When a surgery is done externally, a surgeon must not take too much skin or else you can change the shape of the eye or cause an ectropion or malposition. These occur when the lid doesn’t sit against the eye, creating a medical and cosmetic deformity.
When a patient is young, has had previous surgery and has some residual fat, the trans-conjunctival incision — inside the eye — is done. This means you can remove the extra fat without an external incision.
Another reason to do this is when a patient has a malposition of the lid where some of the white part of the eye is seen between the iris and the lower lid. By making the incision inside the eye, a cut is made through some of the lid’s depressor muscles. This way, you get some elevation so that the eye looks more normal after surgery.
When looking to have your eyes done, you should pick a facial plastic surgeon, oculoplastic surgeon or plastic surgeon who does facial surgery.
Dr. Carlos Wolf is a partner in Miami Plastic Surgery and is board certified. Email questions to him at Cwolf@miamiplasticsurgery.com
